Peptic Ulcer

About Peptic Ulcer

A peptic ulcer is a sore on the lining of your stomach or duodenum. Rarely, a peptic ulcer may develop just above your stomach in your esophagus. Doctors call this type of peptic ulcer an esophageal ulcer.

People of any age who take NSAIDs every day or multiple times per week are more likely to develop a peptic ulcer than people who do not take them regularly. NSAIDs are a class of pain killers, such as aspirin and ibuprofen. Long-term use of NSAIDs can cause peptic ulcer disease.

What works? Research summarized

Evidence reviews

A perforated peptic ulcer can be repaired using either open surgery or laparoscopy, a minimally invasive surgical technique sometimes known as 'keyhole' surgery. Three randomized controlled trials were identified that compared the two methods. These trials included patients with clinical suspicion of perforated peptic ulcer that was confirmed at surgery. Both laparoscopic and open repairs were made with an omentum patch or fibrin sealant. The primary outcomes assessed were septic abdominal and extra‐abdominal complications. Secondary outcomes assessed were mortality, operation time and hospital length of stay. The quality of the trials was acceptable. There were no statistically significant differences in septic abdominal complications between laparoscopic and open repair of perforated peptic ulcer. More randomized controlled trials with a greater number of patients are needed to confirm such an assumption, guaranteeing a long learning curve for participating surgeons.

Peptic ulcers are caused by acidic stomach juices damaging the lining of the stomach (gastric ulcer) or upper small intestine (duodenal ulcer). This causes pain, indigestion and sometimes bleeding. Bleeding in the gut can be life‐threatening. Several treatments aim to heal the ulcer and prevent future bleeding. These include acid‐suppressing drugs and antibiotics to treat Helicobacter pylori, a bacterium that causes most peptic ulcers. The review found that, for people who have had a bleeding peptic ulcer caused by Helicobacter pylori, treatment with antibiotics more effectively prevents gastrointestinal re‐bleeding than acid‐suppressing drugs. Antibiotics when Helicobacter pylori infection is present are also cheaper and more convenient than long‐term acid‐suppressing drugs.

Summaries for consumers

A perforated peptic ulcer can be repaired using either open surgery or laparoscopy, a minimally invasive surgical technique sometimes known as 'keyhole' surgery. Three randomized controlled trials were identified that compared the two methods. These trials included patients with clinical suspicion of perforated peptic ulcer that was confirmed at surgery. Both laparoscopic and open repairs were made with an omentum patch or fibrin sealant. The primary outcomes assessed were septic abdominal and extra‐abdominal complications. Secondary outcomes assessed were mortality, operation time and hospital length of stay. The quality of the trials was acceptable. There were no statistically significant differences in septic abdominal complications between laparoscopic and open repair of perforated peptic ulcer. More randomized controlled trials with a greater number of patients are needed to confirm such an assumption, guaranteeing a long learning curve for participating surgeons.

Peptic ulcers are caused by acidic stomach juices damaging the lining of the stomach (gastric ulcer) or upper small intestine (duodenal ulcer). This causes pain, indigestion and sometimes bleeding. Bleeding in the gut can be life‐threatening. Several treatments aim to heal the ulcer and prevent future bleeding. These include acid‐suppressing drugs and antibiotics to treat Helicobacter pylori, a bacterium that causes most peptic ulcers. The review found that, for people who have had a bleeding peptic ulcer caused by Helicobacter pylori, treatment with antibiotics more effectively prevents gastrointestinal re‐bleeding than acid‐suppressing drugs. Antibiotics when Helicobacter pylori infection is present are also cheaper and more convenient than long‐term acid‐suppressing drugs.

Peptic ulcers are caused by acidic stomach juices damaging the lining of the stomach (gastric ulcer) or upper small intestine (duodenal ulcer). This causes pain, indigestion and sometimes, bleeding. Ulcers can return after being healed, especially if the person is infected with Helicobacter pylori (a lifelong infection unless treated). Helicobacter pylori (or H. pylori) causes most peptic ulcers. The review of trials found that antibiotics for H. pylori have a small benefit in initial healing of duodenal ulcers and a significant benefit in preventing the recurrence of both gastric and duodenal ulcers once healing has been achieved. In summary, when people with peptic ulcers have Helicobacter pylori infection, antibiotic treatment can help speed initial healing of some ulcers and can prevent ulcers returning

A procedure that uses an endoscope to examine the inside of the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

A group of symptoms that occur when a tumor called a gastrinoma forms. The tumor, which can be cancerous, releases large amounts of the hormone called gastrin. The gastrin causes too much acid in the duodenum, resulting in ulcers, bleeding, and perforation.